Alendronic Acid

[MarsiJay]

My GP has prescribed AC 70mg once a week as a preventative against bone loss while taking 10mg of prednisolone. I wonder if anyone has feedback about this.

[piglette]

Have you had a Dexascan to check your bone density? Personally I would not take AA until someone proved I needed it.

[Runrig01]

I agree I would only take if dexa scan warrants it. I took it for 2.5yr, had to stop this summer as I had stress fractures in both ankles (18 months apart), that has been attributed to AA. In the USA stress fractures of the distal fibula are listed as a side effect, although it is more commonly the femur that is affected.

[MarsiJay in reply to Runrig01]

Wow. That does give me pause for thought. Hope you are well now. Many thanks.

[Runrig01 in reply to MarsiJay]

Ankles are fine now thanks. I believe it is only 1% of side effects that result in the fractures I had, so guess I was just unlucky. Also my dexa scan showed moderate osteopenia, t-score was -1.91. So I wouldn't worry too much. Take care x

[MarsiJay in reply to Runrig01]

You too and thanks again

[PMRpro Ambassador]

As the others have said - ask for a dexascan first to see if you need it. I lost no bone density in over 3 years while on doses of pred that were well above 10mg, sometimes as much as 20mg. Only about half of patients taking pred have a problem with their bone density - and there isn't actually any proof that it was definitely the pred if they hadn't had a dexascan at the start of their treatment before any problems could develop. It is recommended you shouldn't take bisphosphonates for more than a maximum of 5 years without a holiday from it to reduce the risk of side effects - so it makes far more sense to wait until it is really shown you will need it. That means a dexascan now and a repeat in a couple of years if the first is OK.

[MarsiJay in reply to PMRpro]

I had a scan some years back and was fine. I appreciate what you say because some side effects are what I suffer from already. I shall consider speakin to my GP again. Thanks again.

[DorsetLady PMRGCAuk volunteer]

Hi,

I have taken AA for the last 3.5yrs as I fall into the group of those susceptible to osteoporosis.

I take it Sunday mornings when I know I'm not in a rush to go anywhere. Take it first thing with plenty of water, have a shower, dress etc. Sometimes Skype daughter in NZ. By then enough time has passed to have breakfast and take rest of tablets.

I have felt a bit nauseous a couple of times, but that's all. If you drink plenty of water, and make sure you don't lie down or bend over its ok.

It does have adverse effects on some, so get as much info as you can before taking - like any other drug really.

[MarsiJay in reply to DorsetLady]

Thanks for this reassurance. I believe some can suffer vertigo which I already suffer from. But nothing ventured etc.

[HeronNS]

I personally would do a lot more research before agreeing to take any of the OP medications. Prednisone is one thing - there is no alternative. There are, however, alternative treatments for OP which do not involve drugs that come with their own slate of dangerous side effects. But you will make the right choice for you. Best wishes!

[MarsiJay in reply to HeronNS]

I think as you H. I take the lowest dose of prednisolone to relieve pain and am wary of adding to the armoury of medications I take already.

[HeronNS]

This article is from 2008 so there's no doubt newer information, but it says that Vitamin D and calcium are as effective as the medications in combatting corticosteroid-induced osteoporosis. australianprescriber.com/ma...

[MarsiJay in reply to HeronNS]

Great info. Thanks

[PMRpro Ambassador in reply to MarsiJay]

Please see my response to HeronNS

[PMRpro Ambassador in reply to HeronNS]

Yes it does say that - but it also says that patients at higher risk of fracture should be offered bisphosphonates, and that means people who have either already got into the osteoporitic range before starting on pred (hence the need for the baseline dexascan) or for whom the calcium and vit D doesn't work adequately - and there are some (hence the need for a follow-up scan after a couple of years.

Giving calcium and vit D supplements is the first line approach and is the one with fewest side-effects. However, monitoring is essential to be sure that approach is working in each individual patient. If it doesn't - another approach is needed.

[Maxine-59]

I have been on high dose Pred for GCA since Aug and was prescribed AC and VIT D from the start - I would rather take those as a post menopausal lady than to risk fractures 😀

[MarsiJay in reply to Maxine-59]

Good to know it suits you Maxine. Thanks

[Adnamaxx]

Oh my goodness....had bone scan and rheumatologist started me on A A to be safe not had test results yet.....just blindly taken it without thinking of any possible side effects...my mother has had it for years....This site really makes me think and learn...Thank you. Going to see him again on Friday ... which is the day I picked to take it .. hope it will be unnecessary

[pollyg263]

Yes I was prescribed it only took it for 6months, I wasn't happy with Ll the bad reports, also my dentist wasn't very happy I have read that not all people need to take it.as there bone density is OK also I had side effects I take calceos . For my bones there will be plenty of people will be along to give there views

[MarsiJay in reply to pollyg263]

In fact Polly the replies I've had are consistent with yours. I am not going to risk my quality of life when I don't think I need it. Shall see my GP and tell him. Thanks Polly

[Ida-June128]

I took it for two years; after one year a stress fracture of femur that then snapped and after second year a stress fracture of the other femur which I am trying to manage (!). The Dexa scan showed my bone density was twice that expected of a person of my age so I certainly didn't need it.

[MarsiJay in reply to Ida-June128]

Thanks to the replies I am receiving, I have made the decision not to take it. Shall see my GP to discuss it but unless I have convincing proof that I absolutely need the drug I am not going to risk it. Many thanks to you.

[Ida-June128 in reply to MarsiJay]

If it helps.....over to the experts.....I have been researching Forteo...appears to be another bone helping formula although I believe it may be more associated with bone growth. I asked my surgeon if it would help with my non repairing pinned femur but he had never heard of it.

Does anyone know anything about it please?

[MarsiJay in reply to Ida-June128]

Maybe it is one from the 'alternative' side. There is one called Strontium too which has good reviews and which I may consider.

[Ida-June128 in reply to MarsiJay]

It's not an alternative...teriparatide is the drug name, manufactured by Eli Lilly. Worth Googling perhaps/

[MarsiJay in reply to Ida-June128]

Just done so. Seems it must be given by injection.

[Celtic PMRGCAuk volunteer in reply to Ida-June128]

Hello Ida-June, my aunt in her late 80's was prescribed Forteo for two years following a spinal fracture. No doubt due to the high cost, her consultant had to seek permission to prescribe it. Following the daily injections for two years, it proved very successful for her and now at the age of 90 she has been off the treatment for more than a year.......and is back at the gym and sequence dancing!! It appears to be the only medication that can successfully actually build new bone.

[Ida-June128 in reply to Celtic]

That's very good to hear. I may try and push for it to encourage bone growth around titanium rod in left femur that is not knitting due to the pred.

[PMRpro Ambassador in reply to Ida-June128]

I think I might have suggested he googled it - I can't believe he hasn't heard of it, even the NHS uses it when required!

[HeronNS in reply to Ida-June128]

Dr Google says it (teriparatide) is a synthetic parathyroid hormone, involved in regulating calcium metabolism. WebMD has an interesting few paragraphs on the use of strontium for bone strengthening.

[MarsiJay in reply to HeronNS]

I'm tempted to try strontium. Thanks for the ref.

[TyWyn]

Hi so glad to read this post. I too was prescribed AA after being diagnosed with PMR and just started taking it without having had Dexascan. I was unaware of the stress factor side affect. Thank you everyone for highlighting this.

[MarsiJay]

I second that T

[HeronNS]

I want to start off by saying that I understand different people will have different priorities and will make different choices and I don't want to imply criticism of those choices. I know that doctors seem to be pretty much required to offer the OP drugs upon diagnosis. I've done a lot of reading. There is nothing I can find that convinces me that these front line drugs are a good option, not even the articles that recommend them. The first few paragraphs make them sound amazing, then a little further along you see the possible side effects, in most cases (in my opinion) worse than the disease. My GP tried to talk me into a prescription the other day and when I once again said that I was going to go the all natural route (nutrition, exercise, weight bearing, etc.) she said there was probably not much point referring me to the OP specialist. (BTW this is the same appointment where she told me all the information she had was the summary of my scan results. Neither of us knows the actual measurement of my BMD or my T score.)

[MarsiJay in reply to HeronNS]

I agree with you. Many patients appear to suffer side effects that mirror my symptoms. Add to this the risk of spontaneous fracture and they really have lost me.